Three Common Running Overuse Injuries: Causes, Prevention, and Treatment

overuse injuries

Running is great exercise, but it is also notorious for leading to overuse injuries that can derail even the most elite runner’s training plans.

If you were to ask a runner why he or she loves running so much, you would get a multitude of answers ranging from stress relief to weight loss to maintaining a healthy lifestyle.  If you were also to ask a runner what his or her biggest fear is, you would likely hear that the fear of injury is what keeps them up at night.  Three of the most common overuse injuries that runners face are Achilles tendinitis, iliotibial band syndrome, and plantar fasciitis.  In most cases, these types of injuries are the result of training errors such as increasing running intensity or duration too quickly or running on poor surfaces.  Wearing the wrong or worn out footwear and not taking adequate recovery time are two other major factors.  Fortunately, there are several ways to prevent these injuries, but if it is too late, there are also many ways to effectively treat these conditions.

Achilles tendinitis is pain in the back of the heel that occurs as a result of repetitive strain on the Achilles tendon.  This is usually caused by increasing mileage too quickly, running on hilly terrain, or wearing worn out running shoes.  It is most common in the middle-aged population but also affects those with flat feet, tight calf muscles, or people who are overweight.  Some easy ways to prevent Achilles tendinitis are by gradually increasing activity level, warming up before running, resting when necessary, wearing the right running shoes, and stretching.  Cross-training, which includes swimming, elliptical, or cycling, is another great way to reduce stress on the tendon while still maintaining cardiovascular fitness.  In the event that it is too late for prevention, there are several treatment options to address this injury.  The first step is R.I.C.E which stands for rest, ice, compression, and elevation.  At the first sign of injury, resting from running, applying ice to the painful area, wrapping the injured area, and elevating the ankle, are some effective ways to reduce pain and inflammation.  If the symptoms are more severe, it may be beneficial to consult with a doctor for a possible prescription of NSAIDs such as ibuprofen or naproxen, and a referral to physical therapy.  A physical therapist can help by educating the patient about the injury, recommending orthotics, teaching stretching and strengthening exercises, and performing manual techniques and modalities to help reduce pain.

Iliotibial band syndrome, or ITBS, is another overuse injury that many runners face.  The IT band runs along the outside of the thigh from the hip to the knee and most commonly becomes inflamed at the knee.  As the IT band comes into the knee, friction can occur between the band and the bone resulting in pain, swelling, and tenderness.  IT band syndrome, like Achilles tendinitis, happens as a result of training errors or improper footwear.  Women and those who frequently run downhill or on the same side of the street are also more susceptible.  A women’s hip alignment often results in an inward turning of the knees placing more strain on the ITB.  This interior rotation of the hip and knee also occurs when running on one side of the road, as roads are often banked near the sides, causing one leg to turn more inward.  Prevention includes changing the running surface, cross-training, resting, proper warm up, stretching, and the right footwear.  A physical therapist can help a runner with ITBS by performing manual techniques, modalities such as cold laser and electrical stimulation, providing stretches, and teaching hip strengthening exercises.

Perhaps the most dreaded of all running injuries is plantar fasciitis.  Plantar fasciitis is pain and inflammation occurring in the plantar fascia, or the thick band of tissue that runs along the bottom of the foot from the heel to the toes.  The pain is usually sharp and worst with the first few steps in the morning.  It tends to worsen with prolonged standing or running long distances.  Plantar fasciitis affects people with flat feet and high arches alike, making proper footwear an essential piece of recovery and prevention.  Inadequate support in the arch leads to an overstretching of the fascia that results in tiny tears that ultimately lead to inflammation and pain.  Tenderness is usually found at the heel.  Patients who first seek treatment with a doctor may have x-rays taken.  An x-ray will sometimes show a bone spur at the heel as a result of repetitive strain on the fascia.  Similar to a case of Achilles tendinitis or ITBS, NSAIDs and R.I.C.E can be effective early treatment methods.  Physical therapy can assist in improving ankle stability, flexibility, and decreasing pain and inflammation.

Running injuries can be frustrating and time consuming if not addressed properly.  The best way to avoid these injuries is to follow a proper and varied training schedule, perform stretching and strengthening exercises, and seek out the correct footwear.  Running specialty stores can be a great place to find knowledgeable staff who can guide runners to the correct shoe.  Running shoes should also be replaced every 300-500 miles depending on running style, surface, and body weight.  In the event that all preventive measures fail, a physical therapist can be a great resource to help get a runner back on track as quickly as possible.

Originally posted prnewswire.com                                                                                                                                        20th August 2013

For a more detailed discussion about the management of these injuries follow the links Dealing With Achilles Tendinopathy and Dealing With Heel Pain: Plantar Fasciopathy or  contact one of the physiotherapists at Jubilee Sports Physiotherapy.

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